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Crafting Wellness Efforts for Those Most in Need of Them

Targeting employees with health risks had the greatest impact

A man is using a laptop to monitor his blood pressure.

Employers often spend hundreds of dollars per employee on health programs that fail to help those with the highest health risks. A recent report, What Do Workplace Wellness Programs Do? Evidence from the Illinois Workplace Wellness Study, uncovered program failings that should give employers pause.

The study focused on a wellness program available to 12,000 employees at the University of Illinois at Urbana-Champaign, and it found that workers who participated in the program tended to be healthier than nonparticipants and to earn higher incomes.

Because wellness programs often reward participation and success by offering lower health-plan premiums and other financial incentives, unhealthier and lower-paid employees who don't take part may face the double whammy of higher premiums and higher out-of-pocket costs when they incur larger health care expenses than their peers.

Expanding the Reach

The largest share of health care spending is concentrated on a relatively small portion of the population. If wellness programs don't reach these less-healthy people, employers won't be able to rein in health care costs.

The Illinois Workplace Wellness study, for instance, found that "all else equal, reducing the share of nonparticipating employees [in wellness programs] by just 4.5 percentage points would lower total medical spending in our setting by an amount sufficient to pay for our entire wellness program.

To draw in at-risk employees, start by identifying what keeps less-healthy people from participating and succeeding in wellness activities and then find ways to remove or lower those barriers, the study concluded.

"A one-size-fits-all approach to wellness only accommodates those who are most confident and are already living a wellness-centered life," said Lizzie Alberga, founder of Collective Gain, a wellness coaching firm based in Los Angeles. "Not everyone wants to do yoga in front of their co-workers or publicly participate in a weight-loss challenge."

She advised offering a variety of wellness options, including those that allow employees to participate in private, away from their colleagues and the workplace.

Others agree. Kelly Morrow Baez, a wellness trainer in Columbus, Ga., advised finding ways to drain some of the emotion from wellness activities. For example, "a weight-loss competition could be emotionally difficult for some people, but a stress management initiative will be helpful" because the skills participants learn could also help them lose weight, she said.

[SHRM members-only toolkit: Designing and Managing Wellness Programs]

Building Trust

After a few years of less-than-ideal results, the government of Collier County, Fla., took a new approach to the wellness program it offers its 2,200 employees. It focused on helping employees overcome emotional barriers to improving their health. The rationale was that, if emotional issues cause people to eat poorly, drink too much and mismanage their stress, that has an enormous impact on their physical health and the amount of health care services they need.

So Collier County adopted a more personalized approach to wellness. It began with focus groups to identify employee concerns about sharing health data, followed by extensive biometric screening to identify potential health problems. Based on those results, Collier County started a program grounded in personalized, one-on-one coaching relationships.

"The key was to gain employee trust," said Jo Steinberg, CEO of Midland Health, a wellness consulting firm based in Milwaukee that provides services to Collier County. "The coaches help participants understand their test results, how they can make changes to address any issues and what might happen if they don't make changes."

The coach can also help the employee identify and discuss any emotional issues that might be preventing the worker from adopting a healthier lifestyle, such as feeling overstressed or depressed. A coach might then want to discuss how better eating and exercise habits can help alleviate these emotions and to steer the participant toward grocery-shopping classes and other resources.

The best results come from "a high level of human touch," Steinberg said.

Five Tips for Successful Programs

The government of Collier County, Fla., has seen strong success with its wellness program. Jeff Walker, the county's division director of risk management, offered these suggestions for fine-tuning wellness efforts.

  • Focus limited resources on people with a greater number of risk factors. The aim should be to reach those who need help the most.
  • Don't bite off too much, especially in the beginning. It is better to do a few things in an exceptional manner than a lot of things poorly.
  • Look at the program from the employees' point of view. Is it easy to understand? Do they know what they have to do?
  • Nurture the perception that participating in a wellness program is a rewarding experience. Don't sacrifice high-touch service just to save money. For example, offer face-to-face coaching if possible. Celebrate successes. Share with program participants—and potential participants—when someone sends a note stating that the program improved his or her quality of life, especially when someone says, "This program saved my life."

Leadership Support Pays Off

Well-being programs designed to improve employees' physical and emotional health fared better when leaders were visibly supportive and involved, stated a December 2018 progress report from the nonprofit Health Enhancement Research Organization (HERO) and Mercer, an HR consultancy.

Companies reported better outcomes when leaders recognize employees who have achieved success, and when leaders actively participate in health and well-being initiatives themselves—two relatively simple and low-cost ways to boost performance, according to responses from about 1,000 employers in the HERO Scorecard database.

Publicly recognizing employees for their wellness efforts and achievements was most associated with higher participation rates. Organizations that did so reported:

  • An average health-assessment completion rate of 61 percent of eligible employees, versus 48 percent for organizations in which leaders did not recognize employees for their healthy actions and outcomes.
  • Greater measurable improvements in population health and medical plan cost when compared to companies that did not recognize employee success.

"Leadership support costs very little … and can be as simple as celebrating employee efforts or sharing personal well-being goals and practices," said Steven Noeldner, senior total health management consultant at Mercer.

Joanne Sammer is a New Jersey-based business and financial writer. 

Related SHRM Articles:

Wellness Programs Show Modest Benefits, as Efforts Pivot to 'Well-Being', SHRM Online, June 2020

The Right Ingredients Brew Wellness Program Success, SHRM Online, March 2018

Does a New Study Underestimate Wellness Programs?, SHRM Online, February 2018


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